|Type of paper:||Research paper|
1. What are the facts of this case?
This a case of an anesthesiologist that has developed a habit of sleeping in the operating room (Buchbinder, 2013). The director of the OR is well aware of this as he has witnessed it first-hand. One day, one of the nurses takes a photo of the anesthesiologist sleeping in the OR. The photo spreads widely and eventually reaches the vice president in charge of medical affairs at the hospital, and the president. At this point, the chairperson of the anesthesia department summons the anesthesiologist in question.
2. What is the nature of the organizational behavior problem?
This organizational behavior problem is twofold because it is both an employee issue and a team problem. The problem qualifies as a team problem because the people that express concern, such as the nurse, are members of the team in the operating room. Additionally, the problem appears to affect almost every member of the organization - the whole organizational team is impacted.
3. Which theory or theories do you believe best explain the behaviors of the anesthesiologist's coworkers?
The theory that would precisely describe the behavior of the coworkers of the anesthesiologist is the legitimacy theory, which, according to Pittroff (2014), informs the act of whistle-blowing. According to Tilling (2004) the legitimacy theory is based on the presumption that the effort with which a tendency acts are directly connected to the outcome of the act, and the extent to which such an outcome meets the expectations and traditions of the environment in context. The co-workers acted upon this incident because they were aware that all employees are expected to work competently, and that anything contrary to that should be reported.
4. Is this a case of an impaired* (see definition below questions) physician? What data would you have to collect to document impairment?
This is a case of an impaired physician, because much of the facts reveal that she is not able to work competently following her sleep deprivation condition. To establish whether the employee is an impaired physician, I would need to collect data that would prove that the anesthesiologist has such an impairment as sleep deprivation (Mossman, 2011). Secondly, I would seek to establish her inability to perform or work professionally. Also, I would collect data establishing that the accused person exhibits significantly decreased patient safety concern (Johnson, 2009).
5. Should the anesthesiologist be referred to an Employee Assistance Program (EAP) or a Physicians' Health Program (PHP)? Why or why not? Provide a rationale for your responses.
The anesthesiologist should be referred to a Physical Health Program because their problem is rooted in their physical well being. Mossman (2011) argues that all healthcare institutions have the PHP program to deal with cases of impaired practitioners. According to Mossman, such people should be referred to the PHP because approaching them as a fellow co-worker could only worsen the problem as the impaired individual may be in denial.
6. How would you manage the physician's sleeping on the job if you were her supervisor?
If I were her supervisor, I would recommend a direct referral to the PHP because as Mossman (2011) states, such impaired patients are better off handled professionally and using an impersonal approach because handling the situation at personal level may provoke the will to retaliate. However, as her supervisor, I would seek to know from her what the cause of the issue is so I can make an appropriate referral.
7. What types of ethical issues are identified in this case study?
Notably, there are many ethical issues, ranging from the immediate issue in this case, to some of the steps taken to address the problem. Foremost, it is unethical to show reduced concern for patient safety by such acts as sleeping while at work. Secondly, the manner in which the nurse spread the news is unethical. She should have reported the matter to the concerned authorities in a confidential manner. The spreading of the photo may have some adverse effects on the anesthesiologist's self-efficacy. Also, the OR Director acted unethically by omission - non-disclosure of the fact that the anesthesiologist was impaired.
8. What kind of clinical and financial impacts do you think the anesthesiologist's behavior could have on the hospital if her behavior went unchecked?
The anesthesiologist's behavior could have regrettable clinical mistakes such as the death of the patient as a result of negligence, or the subjection of patients to some avoidable pain. It would create an unpleasant patient experience, raising clinical ethical concerns. The organization could also face severe financial consequences such as the costs of litigation if the patient decides to sue for negligence. If such cases are published, the organization may suffer financial loss in the form of lost clients.
9. Do you think this problem was addressed appropriately? Provide your reflections and personal opinions as well as your recommendations and rationale for addressing this problem.
While Buchbinder (2013) does not reveal what happens to the anesthesiologist after the summoning, it is my assumption that the employee was taken through counselling before being referred to the PHP for further professional assistance. To the extent that the nurse unethically took and distributed the photo, I would say that it was addressed inappropriately. I would recommend that in such a case, the OR Director, who has practically seen it happen should privately summon the culprit. They should hold a friendly discussion with them and try to establish is there is a problem that may need keen professional analysis. At this point, the OR Director would recommend the PHP, if necessary.
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